WO2018220233A1 - Radial-capitellar implant - Google Patents

Abstract

The invention relates to a radial-capitellar implant having a head, a stem and a threaded anchor.

Description

description

Radial head implant

The invention relates to a

 Radial head implant as well as a head therefor, a shaft, a washer, a threaded anchor of a radial head implant and on a

Saw template, a head application tool, a shaft implantation tool, a

 Bone processing tool, a ratchet and method for inserting the radial head implant and a kit.

In a traumatic fracture, a lesion or abnormality of a radial head is often a synthetic substitute in the sense of a

Radial head implant required. On a

Such implant are numerous requirements. Among other things, it is desirable to be able to use an implant minimally invasive.

It is the object of the present invention to provide a head for a radial head implant

Threaded anchor for a radial head implant, a shaft for a radial head implant, a

Washer for a radius head implant, another radius head implant, a saw template, a head application tool, a shaft implantation tool, a ratchet, a

Specify a bone machining tool, a kit, and another method for inserting a radial head implant. The object of the invention is achieved by the head for a radial head implant according to claim 1, the threaded anchor for a radius head implant according to claim 5, the shaft for a radial head implant according to claim 7, the washer for a

A radial head implant according to claim 14 which

A radial head implant according to claim 15 which

A sawing template according to claim 16, the head application tool of claim 17, the shaft implantation tool of claim 18, the ratchet of claim 19, the bone machining tool of claim 20, the kit of claim 21 and the

A method of deploying a radial head implant according to claim 22.

In all of the following, the use of the term "may be" or "may have", etc., is synonymous with "preferably" or "preferably", etc., and is intended to explain embodiments of the invention.

Whenever numerical words are mentioned herein, the skilled person will understand this as an indication of a

numerically lower limit. If this does not lead to any discernible contradiction for the expert, the

For example, a person skilled in the art always uses "at least one" or "at least one" when stating "one" or "one". This understanding is also included in the present invention as the interpretation that a numerical word such as "a"

Alternatively, it may be meant to mean "exactly one", wherever technically possible for a person skilled in the art.

Both are encompassed by the present invention and apply to all number words used herein. Unless otherwise stated below, means proximally to the body center and distal of the

Body center off. In terms of that

Radial head implant is to be understood as proximal and distal with respect to the position of the radial head implant after intended implantation.

The inventive head for a

 Radial head implant has a, in particular rotatable, locking element for fastening, in particular for releasable fastening, of the head.

Preferably, the locking element serves the

 Attaching the head to a shaft of the

 Radial head implant. The locking element is preferably a separate component that can be inserted into the head.

Fastening the head to the shaft in the sense of the invention means in some embodiments that the head is connected to the shaft, but wherein

Relative movements in one or more

Directions or planes are allowed, for example, rotation of the head around the longitudinal axis of the shaft may still be possible; in other

Embodiments means attach a fixing which also prevents rotation of the head.

The shaft of the invention for a

 Radial head implant has a shaft upper part and a lower shaft part. The shaft upper part is to be attached to the head of the

 Radial head implant designed; with others

In words, the head can be attached to the shaft upper part. The shaft upper part can be, for example essentially take the form of a plate or a plate. The lower shank is for insertion into a bone, in particular in the

Medullary cavity of a radius shaft, designed. The

Shank base preferably has a

elongated shape, which is preferably in parts or substantially cylindrical.

The threaded anchor according to the invention for a

Radial head implant has a - preferably self-tapping - thread and at least one, in particular central or decentralized,

Through opening.

In some embodiments, the thread for the manufacture and warranty of the

Primary stability of the radial head implant

designed.

In some embodiments, the threaded anchor on its outward-facing part is configured to promote osseointegration,

for example, by a macro or

Microstructuring and / or a coating. The inward portion (the central

Through hole) is in some embodiments, however, smooth (eg polished, coated and / or hardened), so that this part can slide against the shaft, has only low frictional forces, minimizes the abrasion behavior and / or the

Osseointegration is inhibited.

In some embodiments, the threaded anchor is at its outwardly directed portion with a rougher

Surface as its inward-looking component (the central passage opening) designed. This may optionally apply regardless of the thread.

The washer according to the invention for a

Radial head implant is for insertion between shaft upper part and bone, in particular between the distal surface of the upper shaft part and

Radius shank configured. The washer is preferably used to adjust the desired distance between the radius shank (after resection of the

bony radius head) and the proximal side of the head. It is used to set the

Joint tension (to avoid the phenomenon called over- / understuffing).

The inventive radial head implant has a head (which optionally has a locking element), a threaded anchor and a shaft. These are preferably present separately from each other or are separable from one another, in particular without requiring tools or having to be destructive.

The inventive radial head implant is preferably adapted to be used in a minimally invasive procedure. For this purpose, after a resection of the radial head preferably the shaft with attached threaded anchor in the radius

be pivoted, which is advantageously possible even in very small Resektionshöhlen.

The sawing template according to the invention has a plate with a tongue which is wholly or at least

is attached in sections parallel to the plate, the tongue preferably has a convexity in Direction of the plate has. In some embodiments, instead of the plate, the sawing template may also include a guide configured for an oscillating saw, such as a slot or aperture.

The head application tool according to the invention is designed and provided for receiving the

head according to the invention and for securing the head according to the invention on a shaft inserted in a radius.

The shaft implanting tool according to the invention is in particular designed and provided for insertion of the shaft with threaded anchor or other anchor in the medullary cavity of a radius. In some embodiments, the stem implantation tool may also be used to insert the stem into the bone without an anchor, particularly the threaded anchor.

especially when the shaft is used with bone cement and without anchor.

The bone processing tool according to the invention has a stem and a rasp element arranged laterally on the stem.

The ratchet according to the invention is designed for screwing a threaded anchor into a radius by means of a rotation of the shaft.

Preferably, the ratchet can also be used for explantation with a reverse freewheel.

 Alternatively, in some cases, the ratchet to

Explantation reversed, z. B. reversed, are used, the freewheel is not reversed. The kit according to the invention comprises the radial head implant according to the invention and at least one of the following aids according to the invention:

 Sawing template;

 Head-application tool;

 Shaft implantation tool, ·

 Ratchet; and or

 Bone processing tool.

The method according to the invention for inserting a radial head implant comprises at least one

Plurality (i.e., two or more) of the following

Steps :

 Applying and / or aligning a sawing template to a radius head, a capitulum humeri and / or its joint space, and applying and / or aligning the sawing template along a radius shaft;

 Size determination of the radius shaft and / or

 Radius head;

 Resection of the radial head along a side of a plate distal to the radial head or guide of the saw template, preferably according to the invention;

 Expanding the medullary cavity of the radius by a preferably inventive

 Bone processing tool ·

 Inserting a preferably inventive shaft with threaded anchor in the medullary cavity of the radius with a shaft implantation tool;

 Turning the preferably inventive

Shaft with threaded anchor in the radius with a ratchet; Placing a preferably inventive head on the shaft with a head application tool,

 Locking a locking element of the

 preferably head according to the invention by the head application tool; and

 optional: insert one preferably

 Washer according to the invention.

Advantageous developments of the present invention are the subject of subclaims and embodiments.

If an embodiment is mentioned here, then it is an exemplary, inventive one

Embodiment not to be understood as

is to be understood as limiting.

Embodiments of the invention may include one or more of the above and / or below

Have features in any combination, unless such a person skilled in the art as

technically impossible to recognize.

The locking element is preferably rotatable. Alternatively, the locking element can also be used as an introduction cascade, which is also optional

be closed, executed.

The optionally rotatable locking element of the head is preferably designed for fastening the head to the shaft. For this purpose, the locking element in some embodiments, a bolt with which a part of the shaft can be locked in the head.

The locking element may be in an opening, especially in a blind hole, the head be used. Preferably, the locking element is configured such that its outwardly directed

Surface in a closed rotational position flush with the head contour.

In some embodiments, the latch optionally has the shape of a key bit. The optional rotatable locking element can lock the head on the shaft by the bolt by means of a

Rotation of the locking element optional

positively hooked to the shaft. This allows the locking element secured on the one hand in the head against pulling out of the head and on the other hand, the head on the shaft, preferably positively, fixed.

The locking element is preferably designed such that by turning the

Locking element can result in releasable fastening and / or locking of the head on the shaft.

The locking element preferably has a

Captive on, the so with the head

cooperates, that the locking element is snapped or clamped in the head.

In some embodiments, the captive is not a frictional locking element, not

Clamping screw, no fixing screw and / or no locking pin.

In some embodiments, this has

Locking element no T-profile on. A T-profile can be designed for the positive connection of the shaft with the head.

In some embodiments, this has

Locking element no pin or no

Fixing pin on. The pin or the

Fixing pin could be designed for positive locking of the head on or on the shaft.

In some embodiments, the rotatable

Locking element at least one locking element for at least one rotational position.

The latching element can serve in some cases, the locking element in one or

several rotational position (s) engage. For this purpose, the head is preferably designed to engage with the latching element of the locking element

co. For example, that can

Have locking element as a latching element at least one locking lug, which in at least one

Detent recess in the head, in particular in the opening of the head, can engage.

In some embodiments, the

Locking element in an open

 Rotation position, in which the shaft can be released from the head, and / or in a closed

Rotational position in which the head is attached to the shaft, engage.

In some embodiments, this has

Locking element on a drive. A drive is a device on which a tool can attach and a torque on the locking element can transmit to rotate or otherwise operate the locking element. In this way, for example, the locking element can be rotated (or moved) from an open to a closed position or vice versa.

The locking element can preferably be transferred by rotation about 90 ° from an open to a closed rotational position and vice versa.

In some embodiments, a drive comprises a hexagon socket and / or a slot, in each of which a rotary tool can engage.

In some embodiments, the head is configured to be in operative position in contact with the corresponding capitulum humeri or replacement of a capitulum humeri. In this case, in some embodiments, the head has a smooth or very smooth surface and / or no sharp edges. In addition or alternatively, the material of the head is preferably designed such that a hard-soft mating between head and capitulum humeri results. Alternatively, the material of the head may be configured such that a hard-hard mating results, for example through ceramic surfaces.

In some embodiments, the head has a concave curvature or plate curvature on the side facing the capitulum humeri in functional position.

In some embodiments, the use of the

Radial head implant several, preferably five, different head sizes provided. there the different head sizes preferably have a proportional plate curvature and depth.

The outer contour of the head is adapted for a beneficial radio-ulnar joint effect.

Preferably, the concave curvature and the

Diameter of the head for advantageous radiocapital articulation and / or radio ulnar

Articulation adapted. In addition, the head is preferably designed such that the articulation between the head and medial side of the trochlea

advantageously leads to a stabilization.

In some embodiments, the shank and / or the threaded anchor also come in several sizes,

especially in five sizes. In this case, preferably all shaft sizes with all

Head sizes are combined.

In some embodiments, the head may be attached and / or locked to the shaft such that movement of the head is possible, particularly relative movement between the head and shaft, particularly rotation about the longitudinal axis of the shaft, compensating for any incongruity between articulation surface of the head and capitulum humeri. With free rotation of the head, the translational movement of the head perpendicular to the longitudinal axis of the shaft lower part and / or along this longitudinal axis can be free or

be hampered.

In other embodiments, the head may be so on

Shaft be attached to a movement,

in particular a rotation of the head is prevented. With suppressed rotation of the head, the translational movement of the head perpendicular to the longitudinal axis of the shaft lower part and / or along this longitudinal axis thereby be free or obstructed.

In some embodiments, the proximal contour of the head is rotationally symmetric and has a concave surface. The radius of this concave contour in some cases does not correspond in every angular position of the head to the capitulum humeri of the convex curvature of the capitulum humeri. In addition, in some cases, the maximum of the capitulum humeri may shift or wander over the minimum of the head as part of a movement.

In some embodiments, the head has at its bottom, in the use position or

Function position facing away from the capitulum humeri, an opening on. This opening has at least two different dimensions in an extension direction. Preferably consist in one

Extension direction transverse to

 Main extension direction of the opening at least two different dimensions of the opening. In some

Embodiments, the opening is the side of the head.

In some embodiments, the opening at the

Bottom of the head a narrow share and a further share. In some embodiments, the opening has the contour of a keyhole. The contour of a keyhole in some cases consists of one (more or less

complete circle to which a rectangle immediately adjoins with its shorter side. there is the (possibly fictitious) diameter of the circle greater than the shorter side of the rectangle measures.

In some embodiments, the threaded anchor for a radial head implant includes a self-tapping thread for insertion into the cortical and / or cancellous bone. In addition, the threaded anchor preferably comprises a central passage opening to

Inserting a lower body part. The shank is preferably movable within the threaded anchor, in particular in the axial direction of the shank lower part. Preferably, the shaft can not relative to

Threaded anchor can be rotated.

The threaded anchor preferably has a trapezoidal thread, which is particularly preferably self-locking

is designed to counteract a release.

The thread of the thread anchor is in some

Embodiments also with left rotation

self-tapping. This may facilitate explantation in some cases.

Individual degrees of freedom can be achieved at the interfaces between the components (head, threaded anchor and / or

Shank) remain deliberately free to a defined extent, in order, e.g. a physiological setting to the

 To allow articular surfaces of radius, ulna, capitulum humeri and / or trochlea. In some

 Embodiments, the radius head implant has two degrees of freedom: the head is about the z axis

 (Longitudinal axis of the shaft lower part) rotatable and the

Shank is along the z-axis and / or transverse to the z-axis

Axis movable. In other embodiments, the radial head implant has only one of the two said degrees of freedom. In some embodiments, there is no degree of freedom: head and shaft are solid. In some embodiments, the head is movable +/- +/- 1 mm along the x-axis and the y-axis so that there are two degrees of freedom.

In some embodiments, the threaded anchor allows fixation on the isthmus of the medullary canal.

The thread anchor tapers in some

 Embodiments in the distal direction, ie in the direction of the end to be inserted first into the bone. In some embodiments, the

 Basic form of the threaded anchor is a truncated cone in the coaxial, a through hole is introduced and on the lateral surface of a self-tapping thread is applied. The thread is preferably interrupted periodically, for example, two, three or four times along the circular circumference, to carry away the removed bone material.

 In some embodiments, the

 Through opening of the threaded anchor at least one

Transmission element on to transmit a

 Torque from an inserted shaft base to the threaded anchor. Such a transmission element preferably comprises one, two or more

Grooves, notches, protrusions, teeth, protrusions,

 Webs, noses or ridges. The shaft preferably has

Leadership facilities on with the

 Transmission elements of the threaded anchor

cooperate to transmit a torque from the shaft lower part to the threaded anchor. This points to that

Shank base, for example, one or more

Gutter (s) into which the nose (s) of the threaded anchor can engage to a torque from the shaft to transfer the thread anchor. At the same time can or preferably the or the transmission elements of the threaded anchor with the or the

Guide device (s) represent a linear guide, so that the shaft along the longitudinal axis of

Lower part of the shaft remains movable in the threaded anchor after the shaft has been screwed into the radius with the threaded anchor.

The shaft of the invention for a

 Radial head implant has a shaft base, which in some embodiments is configured to be inserted into the through hole of the threaded anchor. The shank base is preferably provided with guide means, which are provided with transmission elements of the threaded anchor

cooperate, so that a torque can be transmitted from the shaft to the threaded anchor.

In some embodiments, the threaded anchor and / or the shank have elements for releasably fixing the threaded anchor to the shank, so that preferably a captive securing of the shank relative to the shank

Threaded anchor yields. In this case, the threaded anchor can be clamped in some cases on the shaft and / or locked there. For example, this can be done at the transition between the lower part of the shaft and the upper part of the shaft

Lower shaft part assume a larger diameter, so that the threaded anchor can be clamped and / or latched there. Thus, a slipping of the threaded anchor from the shaft during the operative

Implantation of the radial head implant avoided. In some cases, the shaft is fitted with a threaded anchor already secured

provided . In some embodiments, the shaft has the

Transition from the shaft lower part to the upper shaft part at least one, optionally circumferential groove. The groove may for example be part of the captive, wherein in the groove, for example, shares of

Thread anchor can engage. The groove can

alternatively or additionally serve

To attach washers to the shaft.

Instead of a groove can / can one or more

Survey (s) may be provided on the shaft, in turn, in one or more groove (s) of the threaded anchor

can engage.

In some embodiments, the upper shank has a retaining pin. The retaining pin is preferably on the head-facing side of the shaft

appropriate. The retaining pin preferably has a smaller cross-section at its portion facing the upper part of the shaft than at a further from the

Upper upper part arranged away section. In some embodiments, the retaining pin takes the form of a mushroom head.

Preferably, the upper shank is after the

 Implantation flush with the radius shaft

resected radial head on. It can do that

 Upper part of the shaft towards the radius bone

directed side preferably an osseointegrative

Have surface. The osseointegrative surface is preferably rough and / or has one

Macrostructure and / or coating on. The other, proximal side of the upper shank preferably has a smooth, in particular hardened and / or polished and / or coated surface, preferably in articulation with the

Radial head little friction and / or abrasion generated and / or by a positive connection between the head and shaft upper part relative movement

restricts or prevents.

Due to a flush with the intended use upper upper part is the primary

Alignment of the shaft and head preferably determined by the resection orientation.

In some embodiments, the retaining pin may be inserted into the opening at the bottom of the head. In this case, a wider proportion of

Retaining pins are preferably inserted into a wider portion of the opening of the head, however

preferably not in a narrower proportion of the opening. By displacing the retaining pin after insertion into the opening towards the narrower portion of the opening, the retaining pin can preferably no longer axially be removed from the opening. In some embodiments, the retaining pin is a mushroom head and the opening has a keyhole shape whereby the mushroom head can be inserted through the round portion of the keyhole and then slid to the narrower portion of the keyhole, taking advantage of the narrower stem of the mushroom head; after moving the mushroom head preferably can not be removed axially from the keyhole.

In some embodiments, this is

 Locking element of the head designed to allow it in an open position, that the

Holding pin is inserted into the opening of the head and that in a closed position it is prevented that the retaining pin is removed from the head. In some embodiments, this will be achieved

realized that the locking element a

Moving the inserted into the opening

Retaining pin along the opening prevents

for example, by a bolt of the

Locking element. Through the bar can

For example, a positive connection between the head

(especially the locking element) and retaining pin arise.

In some embodiments, the stem, which may be cylindrical or conical or otherwise tapered in any embodiment, may also be inserted into the medullary canal without a threaded anchor and anchored there by means of bone cement.

The shaft is used during implantation to be advanced into the medullary cavity of the radius. In some embodiments, after the

Screwing the thread anchor in the radius a relative movement between the threaded anchor and shaft temporarily or permanently possible.

The shaft upper part has, measured by a

 Longitudinal axis of the lower shank portion, an extension in a first direction, which differs from an extent in a second direction. The

 Shaft top, for example, have a boundary, which represents a circular arc whose ends are connected to a straight line. In some

Embodiments, the upper upper part is configured particularly flat and / or has a rounded Outline, which can facilitate the pivoting of the shaft into the radius, especially in a minimally invasive procedure.

Preferably, the material of the shaft has at least one of the following properties: sufficient ductility, minimal abrasion, hard contact surfaces, smooth contact surfaces.

In some embodiments of the head, stem, threaded anchor, and / or washer, each is antibacterial due to its / its material or additional coating

and / or has a structured and / or

coated osseointegrative surface area.

The saw template is used for the precise resection of the radial head. The sawing template is preferably available in several sizes. The sawing template has a plate, in particular a sawing plate, in particular for guiding an oscillating saw (in particular with an oscillating saw blade with an end-face cutting surface). Instead of the plate, the saw template can also be equipped with a differently shaped guide, in particular an opening for guiding an oscillating saw. The plate preferably has a contour in order to apply the plate to the radius, in particular to the radius shank. For this purpose, the plate preferably has an arc which can be applied to the radius head. Through the arc of the radius shaft or the

Radius head are contacted over a large area, which is the leadership of the saw and its stabilization in the Improved cutting process and can act as a sizing.

In addition, the saw template on a tongue, which can be additionally or alternatively applied to the capitulum humeri. In some embodiments, the contour of the plate follows in part

Arc. Parallel to the plate, the tongue is preferably attached via a connecting element. The

Connecting element is preferably mounted perpendicular to tongue and plate. The tongue points

preferably in one part a convexity

(especially in the form of a spoon) in the direction of the plate, that is, the tongue is bulged in the direction of the plate. The shape of the tongue can the size assignment and / or orientation of the

Saw template serve. The saw template can be placed on a radius bone so that the sheet of the plate rests laterally on the radius head or on the radius shank and the tongue is in the joint gap between the radial head and humerus, the tongue with its convexity preferably rests against the concave surface of the radius head. The connecting element is preferably provided with at least one borehole or a passage opening which preferably does not run at right angles to the connecting element. Here through can preferably wires (especially K-wire) for

Fixation of the saw template, for example on

Humerus, to be pushed.

In one embodiment of the saw template, which can be used both left and right, are on the saw template, in particular the

Connecting element, at least two openings attached, preferably one for use on the left and another for use on the right arm. The openings are preferably characterized according to their use, for example with R and L.

The saw template can also be used in some

Embodiments serve to determine the size of the radius head to be replaced. For this purpose, there are preferably in a kit a plurality of saw templates in different sizes, for example in the radius of the arc of the plate and / or the size of the tongue (in particular its convexity)

can distinguish. Additionally or alternatively, the saw templates may differ in their extent in the longitudinal direction, for example, to show the depth of the trochlea.

After placing the appropriate saw template, an oscillating saw can be guided along the distal side of the plate (relative to the radial head), so that the radius or the radial head can be resected in a defined plane. For this purpose, a part of the plate can be used as a handle for handling the plate.

In some embodiments, the saw template may be in

Related to a size doctrine.

The plate can have a guide for a carriage of size gauge. At one in the

 Joint gap introduced tongue can the size gauge along the guide to the radius head

be pushed so that the radial head touches an arm of the size theory laterally. The arm is so deflected by the radius head that a pointer connected to the arm indicates on a scale the size of the radius head. The

Parts of the radial head implant according to the invention and the associated tools can be selected on the basis of the values read from the scale.

As a result, resection can advantageously be carried out in some cases, the one for a subsequent implantation of a

Radial head implant produced optimal condition.

A template having a plurality of circular recesses and which may be associated with a kit may be used to check the size of the radial head after removal. For this purpose, the resected radial head is in the wells

inserted and checked if it is with the dimensions of the

Well matches. The wells are preferably labeled to then select the appropriate radial head implant.

The bone treatment tool according to the invention preferably has a flat stem on which a rasp element is attached to one end on one side. The rasp element preferably runs conically away from the handle at a right angle. In some embodiments, the rasp element has substantially the shape of a truncated cone. The surface of the rasp element is preferably designed like the surface of a rasp or file, thus has, for example

Notches or teeth on.

After resection of the radial head this can be

Bone processing tool with the rasp element in the medullary canal of the radius are introduced. By

Turning the bone treatment tool may be the

Medullary cavity can be extended by cutting. The rasp element preferably has a height that a

minimally invasive introduction into the editing room. In some embodiments, the bone machining tool may have a ratcheting function.

After a sufficient enlargement of the medullary cavity by the bone processing tool, the stem can be inserted with the threaded anchor in the radius. Sufficient means here that the

Diameter of the widened medullary cavity preferably corresponds to the core diameter of the threaded anchor.

The shape of the rasp and the process of widening the bone support (the radius shaft) is preferably such that the shaft is not burst and the bone bearing is not mechanically stressed excessively. The subsequent implantation of the shaft and the screwing of the threaded anchor happen

preferably so that the bone bed is not overly stressed.

In some embodiments, the

 Bone processing tool be carried out in two parts. A first part preferably comprises one

Handle, a handle and / or a ratchet for

 Manipulation (especially for a rotary or

 Pivoting movement about the z-axis of the radius shaft) of the, in particular exchangeable, second part,

in particular a rasp element. The size of the

Rasp can be used preferably step by step from small to large. That's it Rasp element movable in the z-direction of the handle. This can make it possible that the stem always rests flat on the resection surface of the radius shank and thus the rasping direction is predetermined perpendicular thereto.

To insert the shaft with attached

Threaded anchor in the radius, the shaft implantation tool can be used. The shaft implantation tool preferably comprises the

Holding pin of the upper shank, especially at the narrower point of the retaining pin. In addition, in some embodiments, the stem implantation tool may include one or more

Pin (s) in one or more holes / holes of the

Engage upper part of the shaft. The shaft implantation tool preferably has one

elastic element, in particular a spring to fix the retaining pin on the shaft implantation tool. In some embodiments, the shaft implantation tool is or includes a forceps whose forceps surface is shaped to include the retention pin of the shaft.

In some cases, the stem can be fitted with

Thread anchors are introduced as follows: The

 Shaft upper part is first placed with its distal side on the resection surface of the radius shaft.

This may result in the orientation of the

Implant is anatomically correct during and after screwing in and corresponds to the resection surface (xy plane). Only by pushing down pins of the shaft implantation tool, that is by the

Loosening a captive of the shaft

Implanting tool, engages the threaded anchor the thread anchor in the bone. A subsequent one

Rotary movement (in the direction of the thread) and the preferably self-tapping shape of the thread anchor cause the cutting to the distal and thus lead to the anchoring of the threaded anchor in the bone (so-called primary stability).

After inserting the stem with threaded anchor through the stem implantation tool, the threaded anchor can be screwed into the radius. The ratchet can be used for this purpose. The ratchet points

Preferably, elements that can transmit torque to elements of the upper shank.

Preferably, the upper shaft part has one or more openings in which one or more

Pins of the ratchet can intervene. In a

Embodiment, the ratchet at least or exactly each one, two or more pin (s) and / or the shaft upper part at least or exactly each one, two or more opening (s). By pressing the ratchet so a torque of ratchet on shank and threaded anchor can be transmitted, so that the

Threaded anchor is screwed into the radius.

Preferably, the ratchet has a receptacle for the retaining pin of the shaft. In some

Embodiments include the at least one, two or more pins and / or the reception of the ratchet on an attachment of the ratchet. The attachment can be optionally interchangeable and in particular in different sizes. The sizes of the

Essay are preferably to different

Shank sizes adjusted.

In some embodiments, insertion of the

Pin / pins of the ratchet in the shaft to do so lead that the captive of the threaded anchor releases.

A handle of the ratchet preferably has a width of less than 15 mm, more preferably less than 12 mm, more preferably less than 10 mm and most preferably less than 9 mm.

Preferably, the stem of the ratchet is at least 5mm, more preferably at least 7mm, and most preferably at least 8mm wide.

Preferably, the thickness of the stem of the ratchet is less than 6 mm, more preferably less than 5 mm, more preferably less than 4 mm and most preferably less than 3 mm. The thickness of the stem is preferably the ratchet

at least 1.5 mm, more preferably at least 2 mm.

The ratio of width to thickness of the stem of the ratchet is preferably at least 4, more preferably at least 6, more preferably at least 8, and most preferably

At least 9. The said ratio is preferably less than 15, more preferably less than 12 and most preferably less than 10.

The dimensions given for thickness and width of the stem of the

Ratchet are preferably in a range between

1 cm and 8 cm from the point where the ratchet is placed on the shaft, in particular measured from where the retaining pin in the ratchet or its

Essay engages. Particularly preferably, this area is between 2 and 6 cm, completely more preferably between 3 and 5 cm

named place.

In some embodiments, after being screwed into the radius, the shaft remains axially movable (in relation to the longitudinal axis of the shaft lower part) in the threaded anchor, in particular axially displaceable.

Then the head can be put on the shaft with a head application tool. In this case, preferably, the retaining pin of the

Shaft upper part inserted into the opening of the head. By a rotation of the head-application tool, which leads to a rotation of the locking element of the head, the retaining pin is locked in the head and so the head attached to the shaft. Preferably, a quarter turn is sufficient to an open

To convert rotational position of the locking element in a closed rotational position.

To the height (in an axial direction) of the

To adjust joint gaps, the optional

Washer between shaft top and

Resection surface of the radius on the shaft lower part

be attached.

The washer is preferably such

designed that after screwing the

 Threaded anchor by means of the shaft laterally on the

Shank base can be pushed. For this purpose, the washer preferably has a central opening and a recess extending from the hole to one side to the edge of the washer

continues. The recess preferably has a smaller diameter than the lower shank part on Transition to the upper part of the shaft, so that the

Washer slightly elastically deformed,

especially tense, must be in order to postpone it on the shaft bottom can. To one

To facilitate such deformation, the

Washer openings. As soon as the

Washer her destination on the

Has reached shaft lower part and the central opening of the washer surrounds the lower shaft part, the washer relaxes, so that the

Washer not from the shank base

can slip down.

The side of the washer facing the bone bed may, in some cases, be osseointegrated by its surface structure (e.g., by its microstructure and / or macrostructure, coating, etc.) and, for example, smooth on the side facing the shaft.

In some embodiments, this has

Radial head implant surfaces for secondary anchoring. For this purpose, the radial head implant is at least partially provided with a surface for secondary anchoring by ingrowth. In some embodiments, the radial head implant may include specific sites for osseointegration at at least one of the following locations: bottom of the shaft top, threaded anchor, tip of the shaft

Lower shank, washer.

In some embodiments, this includes

 Radial head implant no area for one

secondary anchoring. Thus, the threaded anchor can be anchored primarily by screwing in the Radius, wherein the shaft can remain movable along its longitudinal axis.

In some embodiments, there is a surface for secondary anchoring to the threaded anchor. In this embodiment, the threaded anchor can grow in, but the shaft can remain movable or displaceable along its longitudinal axis relative to the threaded anchor.

In some embodiments, this includes

Radial head implant has a surface for secondary anchoring to the shaft or at least parts of the shaft. Here a secondary anchoring can take place over the shaft. After waxing is then the

Shaft no longer movable along its longitudinal axis.

In some embodiments, this has

Radial head implant surfaces for secondary

Anchoring on the shaft and the threaded anchor on. After ingrowth, the shaft is no longer movable along its longitudinal axis.

In some embodiments, at least two, preferably all, portions of the radial head implant are made of the same material.

In some embodiments, one, several or all parts of the radiating head implant consist of a cobalt-chromium alloy (CoCr).

In some embodiments, one, several or all parts of the radial head implant are made

Titanium, especially grade 5 titanium. In some embodiments, the head of the radial head implant is wholly or partially made of pyrocarbon and / or ceramic.

In some embodiments, the head is made of CoCr, the threaded anchor is titanium (particularly titanium grade 5), and the shaft is made of CoCr or titanium

(especially titanium grade 5).

In some embodiments, the head exists

partly or entirely of pyrocarbon, with shank and thread anchor made of CoCr.

In some embodiments, the head exists

partially or wholly ceramic, with the shank and / or threaded anchor preferably made of titanium

(especially titanium grade 5) exist.

For use with a radial head implant for the humeral capitate, in some embodiments a head is used which comprises or consists of a plastic (in particular polyethylene, in particular highly cross-linked polyethylene, in particular with vitamin E).

By using the same materials for several or all parts of the implant, the risk of galvanic corrosion and cold welding can be reduced or avoided.

In some embodiments, the

Radial head implant according to the invention, the head, the threaded anchor, the shaft, the washer, the

Saw template, the head application tool, the

Shank implantation tool, the ratchet, the Bone processing tool, the kit and / or the method one or more of the aforementioned and / or following advantages.

In some embodiments, through the

Invention the articulation surfaces of the radial head with the capitellum humeri and / or the proximal

Radioulnargelenks be restored. Pain can be alleviated or permanently eliminated and / or mobility (again) made possible. Primary and secondary stability, long service life and / or little or no abrasion can be achieved by the invention in some cases and / or unwanted reactions between tissue and implant can be avoided. The invention can often achieve the correct joint tension and the

Minimization or prevention of luxations or subluxations etc. contribute. Preferably, the invention is biocompatible and does justice to biomechanics.

In some cases, due to the fit of the

Saw template, in particular by the size of

 Template referring to the joint space, the capitulum, the radial head and / or the medial depth of the

 Trochlea, and by the axis - exact alignment relative to the radius shank, the plate as a guide of

 Cut plane in the xy plane serve. By the

 Openings (L / R) can cut this section temporarily for the duration of resection at the distal end of the humerus

(Capitulum humeri) by a Kirschner wire or

Similar be fixed. The cutting plane on the resected radius shank thus has with respect to the

Capitulum humeri and the remaining anatomy has the optimal three-dimensional orientation and has by choosing the right size also by resizing to the particular implant

(Radius head) the corresponding distance between capitulum humeri and resected radius shaft. This means that in the following

Operation course selected and used

Radial head implant is anatomically aligned and has the correct distance to the capitulum (no over- / understuffing) and the articulation to

Radioulnar joint is produced.

In some embodiments, one or more of the following are anatomically reversible: head, threaded anchor, shank, washer,

Radial head implant, saw template, head application tool, shaft implant tool, ratchet, bone dressing tool.

In the following, the method according to the invention will be described by means of preferred embodiments thereof with reference to the appended drawing. However, the invention is not limited to these

Limited embodiments. In the figures:

Fig. 1 shows the inventive

 Radial head implant;

Fig. 2 shows the head according to the invention for a

 Radial head implant;

Fig. 3 shows the head according to the invention in three further views;

Fig. 4 shows the shaft according to the invention; shows the threaded anchor according to the invention; shows the threaded anchor, in which a shaft is inserted; shows the saw template according to the invention and a size gauge; shows the saw template inserted into a joint space; shows the inventive

Bone processing tool; shows the shaft implanting tool according to the invention and the shaft with attached threaded anchor; shows the ratchet according to the invention and the shaft inserted into the bone with threaded anchor; shows the head application tool according to the invention; shows the radial head implant with its locking element in two different rotational positions; shows the locking element of

Head; shows the radial head implant inserted in a radius and the washer of the invention; and Fig. 16 shows the radial head implant with the

Washer in another

 Presentation .

Fig. 1 shows a radial head implant 1 with a head 2, a shaft 3 and a threaded anchor 4. In Fig. La and ld are views from below

or see above. In Fig. Lb and lc side views are shown and Fig. Le, lf and lg show perspective views. In the

lateral view in Fig. Lb is also a

The optional designation "M", which in this case indicates the size of the implant, can also be seen in Fig. 1g, an optional washer 6, which is slid onto the shaft 3. In Fig. 1c, le 1f is one of two (could also be more than two) optional channels 7 in the shaft 3, which interacts, for example, with two lugs 8 in a through-opening 9 (see Fig. 5f) of the threaded anchor 4 and one

Linear guide results, which allows an axial displacement of the shaft 3 in the threaded anchor 4. The grooves 7 and the lugs 8 also allow a transmission of torque from the shaft 3 to the threaded anchor 4, which may be useful when screwing the Radialhead implant 1 or its threaded anchor 4 in a radius bone.

Trough (s) 7 and nose (s) 8 may alternatively be reversed, so that the trough (s) 7 is not provided on the shaft 3 but on the threaded anchor 4, and vice versa. Instead of the channel (s) 7 and the nose (s) 8, other element for producing a positive and / or frictional connection between the shaft 3 and threaded anchor 4 may be provided.

Fig. 2 shows the head 2 of the radial head implant 1 in a view from below (Fig. 2a), from the side (Fig. 2b) and above (Fig. 2d).

In Fig. 2e and 2f is a perspective view of the head 2 from obliquely below or obliquely above

shown. FIG. 2 c shows a section through a longitudinal axis of the locking element 5.

In particular, Figs. 2a and 2e clearly show a

Opening 10 of the head 2.

A first portion of the opening 10 has a larger diameter, and a second portion has a smaller diameter or width (eg, less than the diameter of the first portion). The proportion of the opening 10 with the larger diameter has a circular boundary here. A subsequent rectangle (which in this case again opens into a smaller circle or semicircle) has a smaller diameter or a smaller one

Width up.

First share and second share together may optionally have the shape of a keyhole.

In Fig. 3a to 3c, the head 2 is shown again with the opening 10 and the opening for insertion of the

Locking element 5. 4 shows a plurality of illustrations of the shaft 3 with a lower shaft part 11 and a upper shaft part 12 and the optional groove 7. A retaining pin 13 of the upper upper part 12 here shows a wider, upper part with an optionally circular surface or base surface, based on the lower part. The lower portion of the retaining pin 13 is located between the upper portion and the proximal surface of the

Shaft upper part 12. The lower part of the

Retaining pin 13 here purely optional has a square and no round cross-section.

Two openings 14 are made in the shaft upper part 12. These can be used to transmit a torque from a tool to the shaft 3, for example, to screw the shaft 3 with its threaded anchor 4 in the radius.

The section through the shaft upper part 12 in a plane perpendicular to the longitudinal axis of the shaft lower part 11 results in the example of Fig. 4 is a shape by a (partial) circular arc (alternatively a non-circular, approximately oval (part) arc), whose ends through a straight line are defined. In other words, the cut has the form of a

Circle section. By this flattened shape of the upper shank 12 is the insertion of the shaft 3 in the radius, especially at minimally invasive

Facilitated operations. The shaft 3 can do so

can be advantageously introduced even in a tight operative access in the radius.

Instead of two openings 14, a plurality of openings 14 may be provided. Alternatively, an opening 14 and a stop or the like would be sufficient to the desired form and / or adhesion for the

To ensure tool.

In Fig. 5, the threaded anchor 4 from above (Fig. 5d), below (Fig. 5a) and the side (Fig. 5b and 5c) is shown. Fig. 5f shows a sectional view, and in Fig. 5e, the threaded anchor 4 is shown in perspective obliquely from below. The outer shape of the

Threaded anchor 4 essentially corresponds to one

Truncated cone on which a thread 15 is applied.

The thread 15 of the threaded anchor 4 is

self-tapping, especially when turning to the left, to facilitate removal of the radial head implant.

The thread 15 optionally has different (here purely exemplary three) positions of the circumference

Interruptions 16 to dissipate the bone material released during tapping and / or break the chip.

In Fig. 5 also, the through hole 9 of the

Threaded anchor 4 shown. Also in the

Through hole 9 optionally existing lugs 8 for engaging in the grooves 7 of the lower shaft part 11 can be seen here. The lugs 8 allow an axial displacement of the shaft 3 relative to the threaded anchor 4. In addition, via the grooves 7 and the lugs 8, a torque from the shaft 3 on the

Threaded anchor 4 are transmitted.

Fig. 6 shows representations of the shaft 3 with

attached threaded anchor 4 from above (Fig. 6d), below

(Figure 6a), from the side (Figures 6b and 6c), in section through the longitudinal axis (Fig. 6e), with a detailed view (Fig. 6f) and in one

perspective view obliquely from above (Fig. 6g).

The threaded anchor 4 is optionally detachable in Fig. 6b to 6f and captively jammed on the shaft 3 or locked. For this purpose, the portions of the lower shank part 11 shown in FIG. 6e and enlarged in FIG. 6f engage in the proximal part of the threaded anchor 4 at the transition to the shank upper part 12. The captive, detachable attachment of the

Threaded anchor 4 on the shaft 3 prevents the insertion of the shaft 3 accidental falling out of

Thread anchor 4, which is potentially an operation

could extend or even lead to the threaded anchor 4 is non-sterile. This is prevented by the shown detachable captive.

In FIG. 7, the sawing template 17 according to the invention is shown from the side (FIG. 7 a), from the distal (FIG. 7 b) and, in perspective, obliquely from above (FIG. 7 c).

The sawing template 17 has a plate 18 and a via a connecting element 19 parallel to

Saw template 17 attached tongue 20 on. In addition, in Fig. 7a and Fig. 7c through holes 21 are shown, which continue to the outside in a short hollow cylinder. The passage openings 21 are used to insert wires with which the sawing template 17 can be fixed to the humerus. In this case, only one through-hole 21 is used when operating on the left arm, and only the other

Through hole 21 when operating on the right arm. To avoid confusion between them, the through holes 21 are optionally designated on the connecting element 19, such as R and L.

The plate 18 has the radius head towards a, preferably arcuate, boundary, so that the plate 18 as large as possible on

Can support radius head. The tongue 20 optionally has a convexity in the direction of the plate 18, which serves to better on the concave

Articular surface of the radial head to rest.

The sawing template 17 is inserted before the implantation together with its tongue 20 in the joint space, wherein the arcuate lower boundary of the

Saw template 17 rests laterally on the radius head. Thereupon it is evaluated, whether the

Saw template 17 fits the radius head sufficiently accurately or whether another saw template 17 should be used in a different size. This can be assessed haptically or visually. In this context, the sawing template 17 for

Size determination of the radius head used. If the right size is found, then the

corresponding sawing template 17 into the joint space and placed on the radius and secured with a wire, as shown in Fig. 8a to 8d. Thereafter, the distal surface of the plate 18 may be used to guide approximately an oscillating saw to resect the radial head.

In some embodiments (FIGS. 7d to 7f), the

Saw template 17 in connection with a

Size gauge 43 can be used. The size theory 43 can, for example, with the aid of a carriage 44 of the size teaching 43, which is guided in the plate 18 of the saw template 17, on the

Radius heads are postponed. In this case, an arm 45 of the size gauge 43 is deflected by contact with the lateral edge of the radius head, so that a pointer 45 connected to the arm 41

is deflected. The deflection of the pointer 41 can be read on a scale 42 applied on the size gauge 43. A value corresponds to the

Scale 42 of a certain size of a radius head, so that corresponding implant sizes and size matching tools can be selected based on the scale value.

The size of the resected radial head can be checked with a template, not shown, which has circular recesses of different diameters.

After the resection can a

 Bone processing tool 22 with a rasp element

23 are introduced into the medullary cavity of the radius

(see Figs. 9a and 9b). By pivoting a stalk

24 of the bone machining tool 22 is the

Medullary canal enlarged by rasps. For this purpose, the

Surface of the rasp element 23 z. B. notches or teeth.

In one embodiment (see FIG. 9c) of the

 Bone processing tool 22 with handle 24 has this a slider 39 which along a

 Leaf spring 38 can be moved. At the

 Leaf spring 38, the rasp element 23 is attached.

By moving the slider 39, the Rasp element 23 are pushed through the stem 24. The slider 39 is optional with a

Loss guard 37 equipped, here optionally designed as a latching tongue, which prevents the

Slider 39 from the rasp element 23 away from the handle 24 slips.

The stem 24 of the bone machining tool 22 may be designed as a ratchet.

The rasp element 23 can be interchangeable or

be designed interchangeable, so that z. B.

Rasp elements 23 of various sizes can be used with bone processing tool 22.

In Figs. 9d and 9e, the use of the

Bone processing tool 22 shown. The

Bone processing tool 22 lies with its stem 24 on the resection plane of the radius just on. The axis of rotation of the rasp element 23 is perpendicular to the resection plane. By

Rotary movements of the bone machining tool 22 intersects the conical, sprung by the leaf spring 38 rasp element 23 in the medullary cavity of the radius.

9f and 9g show detailed views of the

 Bone processing tool 22. It can be seen that in the leaf spring 38 optionally a

 Lashing 46 is integrated into the

 Rasp element 23 engages and also to drive the

Rasp element 23 is used. The captive 46 of

Leaf spring 38 is optionally executed in Fig. 9g as a tongue, in a narrow web of the rest Leaf spring 38 extends away and widened at its free end to a circular shape. The tongue is inserted into the rasp member 23 for use of the bone machining tool 22 and transmits

Torques of the handle 24 on the rasp element 23. The rasp element 23 has this optional one of the captive 46, in particular the tongue,

corresponding recess 47.

The rasp element 23 is preferably conical

executed and cuts by rotational movements of the stem 24 and the contact pressure of the leaf spring 38 and slider 39 in a desired, size-dependent depth in the radius.

The rasp element 23 is preferably matched to the dimensions of the threaded anchor 4, as in

9h and 9i can be seen.

In some embodiments, the rasping element 23 may have two or more steps. The conical

Rasp element 23 creates when using the

Bone processing tool 22 by removing bone material space in the radius for the threaded anchor 4 and the shaft 3. The rasp element 23 also cuts the space in the radius freely to the root of the thread anchor 4, so that a screwing of the

Thread anchor 4 is enabled (see the

dashed line in Fig. 9i).

After processing the bone with the

Bone processing tool 22 is the bone ready for insertion of the shaft 3 with the optional

captive threaded anchor 4. The insertion takes place with a shaft implantation tool 25, which is shown in FIGS. 10a to 10c. The shaft implantation tool 25 has an optionally elastic element 26 which is used to fix the retaining pin 13 on

Bone processing tool 22 is used. The

Bone processing tool 22 also has two or more pins 27 which fit into the openings 14 of the

Shaft top 12 can be used to safely and precisely insert the shaft 3 in the radius can. The situation after insertion of the shaft 3, wherein the shaft 3 is still on

 Bone processing tool 22 is attached is shown in Fig. 10a.

In FIGS. 10d to 10f, it can be seen that the

Shaft upper part 12 in the view from above (FIG. 10f) and from below (FIG. 10d), eg, in FIG. B. in the sense of

Circular section, laterally optional flattened. In addition, it can be seen in FIG. 10e that the

Shaft upper part 12 on its flat side

Beveled proximally may be a

Minimally invasive tipping of the shaft 3 in the radius can additionally facilitate.

The inserted shaft 3 with threaded anchor 4 is in

Fig. IIa shown, the threaded anchor 4 is here still on the upper shank 12 and is not in the

Bone screwed. A ratchet 28 can then be applied to the shaft upper part 12, which can be seen in FIG.

11c and lld is shown. By turning the ratchet 28, a torque on the conditionally caused by ratchet 28 shaft 3 can be transferred to the threaded anchor 4, so that the threaded anchor 4 deeper in the

Radius can be screwed. Since the shaft 3 However, axially freely movable in the threaded anchor 4 is present (by engagement or guidance between troughs 7 and noses 8), must by screwing in the

Threaded anchor 4 does not necessarily change the position of the shaft 3.

In Fig. Lle and llf is shown that the

Shaft upper part 12 is optionally configured to lie on the resection surface (they are pointed in Fig llle and llf with arrows) of the radius and so a desired axis of rotation of the lower shaft part 11 with threaded anchor 4 or at least the inclination of

Determine the axis of rotation.

FIG. 11 shows the shaft 3 with threaded anchor 4 in an initial position after insertion. Fig. Llf shows that the threaded anchor 4 - due to the rotation of the shaft 3 - has screwed distally, ie into the radius.

In Fig. 12, a head-application tool 29 is shown, with which the head 2 on the inserted

Shank 3 is placed and / or can be locked after its placement on the shaft 3 with this. The head application tool 29 acts on the

Locking element 5 on.

In the example shown in FIG

Locking element 5 optionally a hexagon socket, in which the head-application tool 29th

intervenes. Other geometric shapes than that

Hexagon socket are also included in the present invention. The head-application tool 29 is moved so that the retaining pin 13 is inserted into the opening 10 of the head 2 and the head 2 is pushed with its opening 10 on the retaining pin 13, in particular in an axial direction of the retaining pin thirteenth

Thereafter, the head 2, in particular in a radial direction, further moved until the retaining pin 13 is in the narrower portion of the opening 10, the retaining pin 13 axially no longer from the head second

can be deducted.

In this position, the retaining pin 13 is locked to the head 2. This is done by rotating the locking element 5 by means of the head application tool 29 from an open to a closed rotational position.

In the closed rotational position prevents z. B. a bolt 30 that the retaining pin 13 slips back into the wider part of the opening 10 back. Thus, the head 2 is fixed relative to the shaft upper part 12 and thus also relative to the shaft 3.

In Fig. 13, the two rotational positions of the locking element 5 are clearly visible, wherein the position of the threaded anchor 4 relative to the shaft 3 is not observed.

Figs. 13a and 13b show the open rotational position, while Figs. 13c and 13d show the closed rotational position

Rotation position shows.

In Fig. 13d is shown in a section that the

Latch 30 is the retaining pin 13 in the way or him in limited his freedom of movement. This results in a form fit, which prevents the

Retaining pin 13 from the narrower in the wider part of the opening 10 (here from left to right) slips. Due to the limitation of the retaining pin 13 can not be removed from the head 2. In the open rotational position, the latch 30 is rotated upwards and releases the wider portion of the opening 10 (FIGS. 13a and 13b). This makes it possible for the

Holding pin 13 by the wider share of

Insert opening 10 in the head 2 or remove it.

Fig. 14 shows the locking element 5. It can be clearly seen that the locking element 5 has an optional hexagon socket, to which the head application tool 29 can begin to a

Torque on the locking element 5 to

transfer .

An optional locking element 31 of the

 Locking element 5 can cooperate with a corresponding recess of the head, so that the locking element 5 can engage in an open and / or a closed rotational position.

In addition, the locking element 5 optionally has an annular captive 36, the z. B. locked in a groove of the head 2.

An optional slot 32 in the locking element 5 can provide the necessary elasticity for latching

provide. In addition, the slot 32 can preferably be used to rotate the locking element 5 with a screwdriver. Fig. 15 shows washers 6 and their use. If it is found after introduction of the radial head implant 1 that the joint gap is still too wide, as indicated in FIGS. 15a and 15b by a gap between the radius and underside of the head 2, then a washer 6 can be corrected into this gap between upper upper part 12 and radius are introduced. The washers 6 can be provided in different thicknesses,

for example, with a thickness of 1, 3 and 5 mm.

In Fig. 16a, a radius head implant 1 is shown, the shaft lower part 11 optionally a z. B.

has circumferential groove 35 for sliding the washer 6 on the lower shaft part 11. The groove 35 may be an axial slippage of the washer. 6

prevent.

In Fig. 16b, a washer 6 is shown in detail.

The washer 6 has a central hole 33, which optionally continues into a slot 34 which extends to the edge of the washer 6. Of the

Slit 34 is preferably slightly narrower than a diameter of the lower shaft part 11, so that the washer 6 for sliding onto the

Shank base 11 must be slightly (pre-) tensioned.

To the elasticity of the shims 6 to

can improve, as shown in Fig. 16b,

Material are removed from that portion of the washer 6, which lies on the slot 34 remote or opposite side of the hole 33. Here an opening is shown, which adjoins the hole 33 or passes into this. If that

Shank bottom 11 has reached the central hole 33 during insertion, the washer 6 relaxes. Thus, the washer 6 is prevented from slipping off the shaft lower part 11 after the complete insertion. This can be achieved by the locking, latching or clamping which can be seen in FIG. 16b.

get supported.

LIST OF REFERENCE NUMBERS

 1 radius head implant

 2 head

 3 shaft

 4 threaded anchor

 5 locking element

 6 washer

 7 gutter

 8 nose

 9 Through opening of the threaded anchor

 10 opening of the head

 11 shank base

 12 upper shaft part

 13 retaining pin

 14 holes or openings in the upper part of the shaft

15 Thread of the thread anchor

 16 interruptions of the thread

 17 sawing template

 18 plate of the saw template

 19 Connecting element of the saw template

 20 tongue of the saw template

 21 passage opening of the saw template

 22 Bone processing tool

 23 rasp element

 24 stem of bone processing tool

25 shaft implantation tool

 26 elastic element of the shaft implantation tool

 27 pens of bone processing tool

28 ratchet

 29 head application tool

 30 latch of the locking element

 31 locking element of the locking element

32 slot of the locking element

33 hole of the washer Slit of washer

All-round groove of the lower part of the shaft

Lashing of the locking element captive of the slide of the

Bone processing tool

Bone tool of bones processing tool Burs of bones processing tool Pointer of size gauge

Scale of the size theory

sizer

Sledge of the size theory

Arm of the size gauge

Lashing of the rasp element of the bone treatment tool

Deepening of the rasp element

Claims

claims 1. head (2) for a radial head implant (1),  wherein the head (2) has a locking element (5) for securing the head (2). 2. head (2) according to claim 1, wherein the  Locking element (5) a bolt (30), a captive (36) and / or a latching element (31) for at least one rotational position  having . 3. head (2) according to any one of the preceding claims, wherein the head (2) for articulation with the  Capitulum humeri is concave on top. 4. head (2) according to any one of the preceding claims, wherein the head (2) has an opening (10) on a bottom with at least two different dimensions in a direction of extension  having . 5. threaded anchor (4) for a radius head implant (1) with a self-tapping thread (15) and with a central passage opening (9). 6. threaded anchor (4) according to claim 5, wherein the  Thread anchor (4) extends distally  has a rejuvenating body. 7 shaft (3) for a radius head implant (1) with a shaft upper part (12) and a  Shank base (11), wherein the upper shaft part (12) is designed for attachment to a Head (2) and the lower shaft part (11) is designed for insertion in a radius. 8. shaft (3) according to claim 7, wherein the  Shaft lower part (11) can be inserted into a central passage opening (9) of a threaded anchor (4), in particular according to claim 5 and / or 6. 9. shank (3) according to claim 7 or 8, wherein the  Shank base (11) has at least one groove (7). 10. shank (3) according to claim 7 to 9, wherein the  Shaft upper part (12) has a retaining pin (13) for cooperation with the head (2). 11. shank (3) according to claim 7 to 10, wherein the  Shaft upper part (12), measured from a longitudinal axis of the lower shaft part (11), an extension in a first direction, which is  differs from an extension in a second direction. 12. shaft (3) according to claim 7 to 11, wherein the  Shaft upper part (12) has a base surface which is bounded by a circular arc and a straight line. 13. shaft (3) according to claim 7 to 12, wherein the  Shaft upper part (12) has at least one bore (14) for transmitting a torque. 14. Washer (6) for a Radial head implant (1) for insertion between shaft (3) and bone. 15. Radial head implant (1) with a head (2), a threaded anchor (4) and a shaft (3) according to claim 1, 5 and 7, respectively. 16. Saw template (17) with a plate (18) and with a parallel to the plate (18) mounted tongue (20) with a convexity in the direction of the plate (18). 17. Head application tool (29) for receiving the head (2) and for securing the head (2) on a shaft inserted in a radius (3). 18. shaft implantation tool (25) for inserting the shaft (3) with threaded anchor (4) in the  Medullary cavity of a radius. 19. Ratchet (28) for screwing in the shaft (3) together with threaded anchor (4) in the radius. 20. Bone processing tool (22) with a handle (24) and a laterally arranged rasp element (23). 21. Radial head implant kit (1) according to claim 15 and at least one of the following aids:  Saw template (17) according to claim 16  Head application tool (29) after  Claim 17  Shank implantation tool (25) according to claim 18  Ratchet (28) according to claim 19 Bone processing tool (22) according to claim 20. Method for inserting a  Radial head implant (1) with the steps:  Applying and / or aligning the sawing template (17) according to claim 16 to a / a  Radial head, a / a capitulum humeri and / or its joint gap and applying and / or aligning the saw template (17) along a radius shaft;  Determining the size of the radius and / or radius head;  Resection of the radial head along a side of the plate (18) distal to the radial head or guidance of the  Saw template (17);  Expanding the medullary canal of the radius by the bone dressing tool (22)  Claim 20;  Inserting a shaft (3) with  Threaded anchor (4) in the medullary cavity of the radius with the stem implantation tool (25) according to claim 18;  Screw in the shaft (3) with threaded anchor (4) into the radius with the ratchet (28)  Claim 19;  Placing the head (2) on the shaft (3) with the head application tool (29) according to claim 17; and  Locking the locking element (5) of the head (2) by the head application tool (29).